Graupel Research Articles

Effects of speculum lubrication on cervical smears for cervical cancer screening: A double blind randomized clinical trial.

Speculum lubrication may help to reduce the pain experienced during Pap-smear collection and hence increase uptake of cervical cancer screening and repeat testing, but there are fears of its interference with cytological results. To determine and compare the adequacy of cervical cytology smears and the mean pain scores of women undergoing cervical cancer screening with or without speculum lubrication. This was a randomised controlled study of 132 women having cervical cancer screening at a tertiary hospital in Nigeria. Sixty-six participants were randomly assigned to the 'Gel' and 'No Gel' groups, respectively. Pap smears were collected from each participant with a lubricated speculum ('Gel group') or a non-lubricated speculum ('No Gel group'). The primary outcome measures were the proportion of women with unsatisfactory cervical cytology smears and the mean numeric rating scale pain scores, while the secondary outcome measures were the proportion of women who were willing to come for repeat testing and the cytological diagnosis of Pap-smear results. The baseline socio-demographic variables were similar in both groups. There was no significant difference in the proportion of unsatisfactory cervical smear results between the two groups (13.6% vs. 21.2%, p = 0.359). However, the mean pain scores were significantly lower in the gel group than in the no gel group (45.04 vs. 87.96; p<0.001). An equal proportion of the participants in each group (90.9% vs. 90.9%; p > 0.999) were willing to come for repeat cervical smears in the future. Speculum lubrication did not affect the adequacy of cervical smears but significantly reduced the pain experienced during pap smear collection. Also, it did not significantly affect the willingness to come for repeat cervical smears in the future. The trial was registered with the Pan-African Clinical Trial Registry with a unique identification and registration number: PACTR2020077533364675.

The Effectiveness of Herbal Poultice in Relieving Pain and Flexibility in Osteoarthritis Patients

Knee osteoarthritis (OA) is a chronic condition that causes joint degradation and primarily affects the elderly, reducing their quality of life and physical movements. The objective of this study was to determine the efficacy of Thai herbal poultice in relieving pain in OA patients. A single-blind, randomized controlled trial was conducted amongst OA patients at Integrative medicine clinic, Chulabhorn International College of Medicine, Thammasat University, Thailand. Participants were randomly allocated to the Thai herbal poultice or the diclofenac gel group (N=30). The main outcomes were evaluated using visual analog scale (VAS), isokinetic testing, goniometer, and knee injury and osteoarthritis outcome scores (KOOS) at different time assessment. Data were analyzed by the paired t-test and analysis of variance (ANOVA). Thai herbal poultice and diclofenac group showed a significant difference in both the VAS pain scores, extension and flexion as well as KOOS scores (P &lt; 0.01 in both groups). In addition, when compared to diclofenac group, Thai herbal poultice group were significantly improve pain score at the sixth time point following the intervention (P &lt; 0.01). Furthermore, no patients have experienced allergic reactions to therapies. In conclusion, Thai herbal poultice showed more efficiency in reducing pain scores than diclofenac gel without causing undesirable side effects.

Noncultured Trypsinized Epidermal Cell Suspension Transplantation After Cryoblebbling Versus Noncultured Nontrypsinized Epidermal Cell Graft Homogenized With Plasma Gel After Dermabrasion for Stable Vitiligo.

Vitiligo treatment is challenging, especially for resistant and stable vitiligo, which requires surgical management. Noncultured epidermal cell suspension has been modified to enhance the treatment outcomes. Comparison of autologous noncultured trypsinized epidermal cell suspension in recipient site prepared by cryoblebbling and noncultured nontrypsinized epidermal cell graft homogenized with plasma gel in recipient site prepared by dermabrasion for stable vitiligo treatment. Interventional comparative study on 30 patients with stable vitiligo, randomly divided into 2 equal groups. Group A: noncultured trypsinized epidermal cell suspension for recipient prepared by cryoblebbling. Group B: noncultured nontrypsinized epidermal cell graft homogenized with plasma gel for recipient prepared by dermabrasion. Afterward, both groups received 3 months of narrow-band ultraviolet B phototherapy. The plasma gel group showed a significantly earlier onset of repigmentation and faster healing ( p = .002* and <.001*, respectively). Overall, repigmentation was higher in the plasma gel group ( p = .037* at the end of the second month). Color matching and patient satisfaction were higher in the plasma gel group, without statistical significance. The cryobleb group showed more recipient site complications, and the plasma gel procedure was relatively easier and cheaper. Plasma gel modification is cost-effective, less time-consuming, does not require trypsinization, and provides rapid, satisfactory, and uniform repigmentation. Cryoblebbing and trypsinization are effective; however, there are more technical difficulties, delayed healing, and delayed onset of repigmentation.

PH-induced complex coacervation of Gel and Agar: Phase behavior and structural properties

In this study, we investigated the behavioral patterns of gelatin (Gel) and Agar in terms of composites and phase separation. As the pH (4.5–7.0) increased, the electrostatic interaction between the gel and the agar weakened, and a decrease in the degree of agglomeration of the microstructure was observed in the confocal laser scanning microscope (CLSM) plots. Specifically, When the ratio of Gel to Agar was 2:1 and the pH was 4.5 (pHopt), a large amount of complex coalescence appeared. The Absorption and fluorescence spectra demonstrated the impact of Agar interaction on the tertiary conformation of the Gel, while circular dichroism (CD) detected changes in its secondary structure. Furthermore, Fourier Transform Infrared Resonance spectroscopy (FTIR) demonstrated that the complexes were produced through electrostatic interactions between the -NH3+ groups of Gel and –COO- groups of Agar. The Gel-Agar coacervation process induced structural modifications, which enhanced the Gel’s thermal stability. The findings of this study are expected to be an essential contribution to the potential application of Gel-Agar coacervates for encapsulating functional ingredients.

A randomized double-blind active-controlled clinical trial on the efficacy of topical basil (Ocimum basilicum) oil in knee osteoarthritis.

Basil is a widely used herb in Persian medicine and is gaining recognition as a functional food worldwide. This trial aimed to assess the effectiveness of a traditional formulation of basil oil in comparison with diclofenac gel in treating knee osteoarthritis, considering its established anti-inflammatory, anti-nociceptive, and anti-oxidative properties. One hundred eligible patients were equally randomized to the traditional basil oil (containing sesame oil) and diclofenac gel groups. They used their respective topical treatments thrice daily for 4weeks. Various measurements were taken at the beginning of the study, 2, and 4 weeks after starting the intervention, including the 8-m walk test, knee pain (based on visual analog scale), flexion angle of the knee joint, analgesic consumption, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. No significant differences were observed between the basil oil and diclofenac gel groups in any of the measured outcomes. However, significant improvements were noted within each group for most variables. Topical application of the traditional formulation of basil oil appears to improve clinical symptoms and certain functional indicators of knee osteoarthritis to a similar extent as diclofenac gel. This suggests that basil oil could be considered an effective management option for this condition. Clinical Trial Registration: https://irct.behdasht.gov.ir/, identifier IRCT2017081711341N7.

Formulation characterization of lecithin organogel as topical drug delivery system for psoriasis: In-vitro permeation and preclinical evaluation.

Psoriasis is a chronic inflammatory and proliferative skin disease that causes pathological skin changes and has a substantial impact on the quality of patient life. Apremilast was approved by the US Food and Drug Administration as an oral medication for psoriasis and is beneficial in mild to moderate conditions for chronic usage. However, 5%-7% of withdrawals were reported due to severe side effects. To address the issue, a localized drug delivery strategy via the topical route may be a viable approach. However, poor physicochemical properties make it vulnerable to passing through the skin, requiring a specialized drug delivery system to demonstrate its full potential via a topical route like lecithin organogel. The formulation was optimized by screening the suitable lecithin type and non-polar solvents based on the gel formation ability of lecithin and the solubility of apremilast in the solvent. The pseudo-ternary diagram was used to optimize the water content required to form the gel. The optimized gel was found to be shear thinning characterized for rheological parameters, in-vitro diffusion studies, and in-vitro skin distribution studies. Preclinical studies in Imiquimod-induced mice showed a better reduction in severity index, cytokine levels, and epidermal hyperplasia from the lecithin organogel group compared to the apremilast oral administration and marketed standard topical gel group. Based on these results, lecithin organogel can be considered a promising approach to deliver molecules like apremilast by topical route in psoriatic-like conditions.

Development and efficacy assessment of polyherbal phytosomal gel for accelerated wound healing

Curcuma longa L. and Plumbago zeylanica L. are renowned for their antioxidant, anti-inflammatory, and wound-healing properties, primarily attributed to their polyphenolic compounds. However, the limited water solubility of these compounds poses challenges to their effective utilization. Encapsulation within phytosomes offers a solution by enhancing bioavailability and permeability. This study aimed to formulate a phytosome-based polyherbal gel incorporating methanolic extracts of P. zeylanica and C. longa to explore its potential in wound healing. Methanolic extracts of P. zeylanica roots and C. longa rhizomes were encapsulated in phytosomes using the lipid film hydration technique. Various phytosome formulations were developed and characterized for encapsulation efficiency, particle size, polydispersity index and zeta potential. The optimized phytosomal dispersion (F7) was integrated into a carbopol-based hydrogel matrix. In vitro release studies demonstrated prolonged release compared to conventional forms. Stability testing confirmed the robustness of the phytosomal gel at 4 °C/60 ± 5% RH. Wound healing activity was assessed using an excision wound model. The phytosomal gel exhibited enhanced wound contraction and reduced epithelization time compared to conventional gel and control groups, signifying its potent wound-healing effect. In conclusion, the polyherbal phytosomal gel, incorporating P. zeylanica and C. longa, holds promise in promoting wound healing, presenting a novel and effective approach in the realm of topical formulations for wound care.

Comparative Study of Topical Application of Injection Tranexamic Acid and Anterior Nasal Packing in the Management of Epistaxis.

Epistaxis, defined as bleeding from the nose, is one of the common ENT cases coming to emergency department. Epistaxis is experienced by at least 60% of the population once in their life time and about 6% of them will require medical attention. The different treatment modalities include: local pressure, application of topical vasoconstrictor substances, or nasal packing depending on personal physician preference. Tranexamic acid (TXA), a synthetic analogue of the amino acid lysine, belongs to a class of drugs known as antifibrinolytics. It acts by reversibly binding four to five lysine receptor sites on plasminogen and can be used in emergency department for reducing the bleeding time in epistaxis. To evaluate the efficacy of topical application of injection TXA compared to cases managed with anterior nasal packing for the treatment of patients with epistaxis. 100 patients presenting with epistaxis in emergency department, above the age of 18years were randomly divided into two groups with 50 patients each. Group 1 were managed with anterior nasal packing with gel foam and Group 2 with topical application of injection TXA. Causes,duration to control epistaxis, and occurrence of rebleeding were recorded. Our study showed homogenous distribution of age and sex among the patients. Bleeding stopped within 10min in 38 patients in group 2 compared to 17 patients in group 1. For 31 patients in group 1, bleeding stopped between 10 and 15min compared to 12 in group 2. In group 1, 8 patients had rebleeding compared to 2 patients in group 2. Our study showed that topical application of TXA reduces the bleeding time and number of rebleeds compared to anterior nasal packing with gelfoam. Since it is easily available in an emergency setup and cheaper compared to gelfoam, it can be used as an elective method in managing epistaxis in emergency department.

The effect of topical 0.5% humic acid gel on male rats with skin ulcer.

Humic derivatives have antibacterial and anti-inflammatory properties. This study aimed to assess the experimental wound-healing effect of 0.5% humic acid gel. A full-thickness skin wound was created on the dorsal side of 24 Sprague Dawley male rats (220-250 g). The animals were then randomly divided into the control, sham, and experimental groups. Skin wounds were bandaged daily using sterile gauze dipped in normal saline, carboxymethylcellulose, and 0.5% humic acid for 21 days. The wound-healing rate was evaluated grossly and histologically at various time intervals post-injury. Wound-healing percentage was significantly higher in the gel treatment group at all time points (P < 0.05). The mean number of inflammatory cells was significantly lower in the humic acid gel group than in the other groups (P < 0.001). Moreover, the number of new vascular cells and fibroblasts were significantly increased in the humic acid gel compared to the control (P < 0.001). These data confirmed that 0.5% humic acid gel accelerates wound healing, probably by anti-inflammatory effects, as well as by promoting vascular and fibroblast proliferation. Therefore, the humic acid gel may be used to improve wound care.

Ex vivo UV-C Protective Effect of Aloe vera

Chronic exposure to UV-C can cause sunburn, skin cancer, oxidative stress as well as photo-aging. Many herbs and plant extracts have recently been recognized as a potential source of sunscreen due to their UV-absorbing properties. Aloe vera L., which has been used for therapeutic purposes by humans for centuries, is also among these plants. In this study, it was aimed to reveal the sunscreen properties of the latex and gel parts of A. vera and the effect of these properties on cells exposed to UV rays. In this study, primarily, the lethal effect of UV-C rays on healthy cells was observed over time. Then, the latex and gel parts of the obtained A. vera plant were separated and spread on the surface of petri dishes as a single and double layer. By adding a determined number of cells of the petri dishes, the protection of A. vera against the lethal effect of 1, 1.5 and 2 hours of UV-C exposure was investigated. According to the study findings, it was determined that both parts of A. vera protect cells against UV-C damage. It is quite remarkable that while all the cells in the control group died as a result of UV-C exposure for 2 hours, vitality was still observed in the double layer latex and gel groups. From this point of view, it has been shown in this study that a protective product that can be made using A. vera can prevent the damages that may develop due to UV-C exposure.

Comparison between oral dydrogesterone versus micronized vaginal progesterone gel in clinical outcome within the first HRT-FET cycle: a retrospective analysis.

The purpose of this study is to compare the clinical efficacy of oral dydrogesterone and micronized vaginal progesterone (MVP) gel during the first HRT-FET cycle. A retrospective cohort study based on a total of 344 women undergoing their first HRT-FET cycles without Gonadotropin-Releasing Hormone agonist (GnRH-a) pretreatment was conducted. All the cycles were allocated to two groups in the reproductive medical center at the University of Hong Kong-Shenzhen Hospital. One group (n = 193) received oral dydrogesterone 30mg/d before embryo transfer, while the other group (n = 151) received MVP gel 180mg/d. The demographics and baseline characteristics of two groups were comparable. We found no statistically significant difference in live birth rate (24.35% vs. 31.13%, P = 0.16), clinical pregnancy rate (34.72% vs. 36.42%, P = 0.74), embryo implantation rate (25.09% vs. 28.36%, P = 0.43), positive pregnancy rate (42.49% vs 38.41%, P = 0.45), miscarriage rate (9.33% vs 3.97%, P = 0.05), or ectopic pregnancy rate (0.52% vs. 0.66%, P = 0.86) between the oral dydrogesterone group and MVP gel group. In the multivariate logistic regression analysis for covariates, medication used for luteal support was not associated with live birth rate (OR = 0.73, 95% CI: 0.32-1.57, P = 0.45). And the different luteal support medication did not have a significant positive association with the live birth rate in the cycles with day 2 embryo transferred (OR = 1.39, 95% CI:0.66-2.39, P = 0.39) and blastocyst transferred (OR = 1.31 95% CI:0.64-2.69, P = 0.46). 30mg/d oral dydrogesterone and 180mg/d MVP gel revealed similar reproductive outcomes in HRT-FET cycles in the study.

Menstrual blood-derived mesenchymal stem cells combined with collagen I gel as a regenerative therapeutic strategy for degenerated disc after discectomy in rats

BackgroundAnnulus fibrosis (AF) defects have been identified as the primary cause of disc herniation relapse and subsequent disc degeneration following discectomy. Stem cell-based tissue engineering offers a promising approach for structural repair. Menstrual blood-derived mesenchymal stem cells (MenSCs), a type of adult stem cell, have gained attention as an appealing source for clinical applications due to their potential for structure regeneration, with ease of acquisition and regardless of ethical issues.MethodsThe differential potential of MenSCs cocultured with AF cells was examined by the expression of collagen I, SCX, and CD146 using immunofluorescence. Western blot and ELISA were used to examine the expression of TGF-β and IGF-I in coculture system. An AF defect animal model was established in tail disc of Sprague-Dawley rats (males, 8 weeks old). An injectable gel containing MenSCs (about 1*106/ml) was fabricated and transplanted into the AF defects immediately after the animal model establishment, to evaluate its repairment properties. Disc degeneration was assessed via magnetic resonance (MR) imaging and histological staining. Immunohistochemical analysis was performed to assess the expression of aggrecan, MMP13, TGF-β and IGF-I in discs with different treatments. Apoptosis in the discs was evaluated using TUNEL, caspase3, and caspase 8 immunofluorescence staining.ResultsCoculturing MenSCs with AF cells demonstrated ability to express collagen I and biomarkers of AF cells. Moreover, the coculture system presented upregulation of the growth factors TGF-β and IGF-I. After 12 weeks, discs treated with MenSCs gel exhibited significantly lower Pffirrmann scores (2.29 ± 0.18), compared to discs treated with MenSCs (3.43 ± 0.37, p < 0.05) or gel (3.71 ± 0.29, p < 0.01) alone. There is significant higher MR index in disc treated with MenSCs gel than that treated with MenSCs (0.51 ± 0.05 vs. 0.24 ± 0.04, p < 0.01) or gel (0.51 ± 0.05 vs. 0.26 ± 0.06, p < 0.01) alone. Additionally, MenSCs gel demonstrated preservation of the structure of degenerated discs, as indicated by histological scoring (5.43 ± 0.43 vs. 9.71 ± 1.04 in MenSCs group and 10.86 ± 0.63 in gel group, both p < 0.01), increased aggrecan expression, and decreased MMP13 expression in vivo. Furthermore, the percentage of TUNEL and caspase 3-positive cells in the disc treated with MenSCs Gel was significantly lower than those treated with gel alone and MenSCs alone. The expression of TGF-β and IGF-I was higher in discs treated with MenSCs gel or MenSCs alone than in those treated with gel alone.ConclusionMenSCs embedded in collagen I gel has the potential to preserve the disc structure and prevent disc degeneration after discectomy, which was probably attributed to the paracrine of growth factors of MenSCs.

The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis

BackgroundPolyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU).MethodsWe searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias.ResultsThe findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71).ConclusionThis study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.

In vivo study on osteogenic efficiency of nHA/ gel porous scaffold with nacre water-soluble matrix

Background/purposeNano-hydroxyapatite (nHA)/ gel porous scaffolds loaded with WSM carriers are promising bone replacement materials that can improve osseointegration ability. This investigation aimed to evaluate the osteoinductive activity by implanting the composition of nano-hydroxyapatite (nHA)/ Gel porous scaffolds as a carrier of WSM via an animal model. Materials and methods: WSM was extracted and nHA was added to the matrix to construct porous composite scaffolds. The dose-effect curve of WSM concentration and alkaline phosphatase (ALP) activity was made by culturing rat osteoblasts and examining the absorbance. Three different materials were implanted into critical size defects (CSD) in the skulls of rats, which were further divided into four groups: WSM nHA /Gel group, n-WSM nHA /Gel group, HA powder group, and control group. Results: WSM (150 μg/mL-250μg/mL) effectively improved the activity of ALP in rat osteoblasts. All rats in each group had normal healing. WSM-loaded nHA /Gel group showed better performance on newly-formed bone tissue of rat skull and back at 4th week and 8th week, respectively. At the 4th week, the network of woven bone formed in the WSM-loaded nHA/Gel scaffold material. At 8th week, the reticular trabecular bone in the WSM-loaded scaffold material became dense lamellar bone, and the defect was mature lamellar bone. In the subcutaneous implantation experiment, WSM-loaded nHA/Gel scaffold material showed a better performance of heterotopic ossification than the pure nHA/Gel scaffold material. Conclusion: WSM promotes osteoblast differentiation and bone mineralization. The results confirm that the nHA/ Gel Porous Scaffold with Nacre Water-Soluble Matrix has a significant bone promoting effect and can be used as a choice for tissue engineering to repair bone defects.

Peptide-Based Hydrogel Scaffold Facilitates Articular Cartilage Damage Repair.

Articular cartilage injury is a common disease in clinical medicine. Because of its special physiological structure and lack of blood, lymph, and nerves, its ability to regenerate once damaged is very limited. In this study, we designed and synthesized a series of self- and coassembled cartilage-inducing functional peptide molecules and constructed a coassembled functional peptide hydrogel based on phenylboronic acid-o-dihydroxy "click chemistry" cross-linking to promote aggregation and signal transduction of mesenchymal stem cells (MSCs) in the early stage and differentiation toward cartilage, thereby promoting the repair of cartilage damage. Three functional peptide molecules were produced using solid-phase peptide synthesis technology, yielding a purity higher than 95%. DOPA-FEFEFEFEGHSNGLPL (DFP) and PBA-FKFKFKFKGHAVDI (BFP) were coassembled at near-neutral pH to form hydrogels (C Gels) based on phenylboronic acid-o-dihydroxy click chemistry cross-linking and effectively loaded transforming growth factor (TGF)-β1 with a release period of up to 2 weeks. Furthermore, chondrocytes and bone marrow mesenchymal stem cells (BMSCs) were cocultured with functional peptide hydrogels, and the results displayed that the coassembled functional peptide hydrogel group C Gels significantly promoted the proliferation of chondrocytes and MSCs. The chondrocyte markers collagen type I, collagen type II, and glycosaminoglycan (GAG) in the coassembled functional peptide hydrogel group were significantly higher than those in the control group, indicating that it can induce the differentiation of MSCs into cartilage. In vivo experiments demonstrated that the size and thickness of the new cartilage in the compound gel group were the most beneficial to cartilage regeneration. These results indicated that peptide hydrogels are a promising therapeutic option for cartilage regeneration.

Cardamonin-loaded liposomal formulation for improving percutaneous penetration and follicular delivery for androgenetic alopecia.

Androgenic alopecia (AGA) has a considerable impact on the physical and mental health of patients. Nano preparations have apparent advantages and high feasibility in the treatment of AGA. Cardamonin (CAR) has a wide range of pharmacological activities, but it has the problems of poor solubility in water and low bioavailability. There are few, if any, researches on the use of nano-loaded CAR to improve topical skin delivery of AGA. In this study, a CAR-loaded liposomal formulation (CAR@Lip and CAR@Lip Gel) was developed and characterized. The prepared CAR@Lip exhibited a uniform and rounded vesicle in size. CAR@Lip and CAR@Lip Gel can significantly improve the cumulative release of CAR. Additionally, CAR@Lip can obviously promote the proliferation and migration of human dermal papilla cells (hDPCs). Cell uptake revealed that the uptake of CAR@Lip significantly increased compared with the free drug. Furthermore, both CAR@Lip and CAR@Lip Gel groups could markedly improve the transdermal performance of CAR, and increase the topical content of the drug in the hair follicle compared with CAR. The ratchet effect of hair follicles could improve the skin penetration depth of nanoformulations. Notably, Anti-AGA tests in the mice showed that CAR@Lip and CAR@Lip Gel groups could promote hair growth, and accelerate the transition of hair follicles to the growth stage. The anti-androgen effect was revealed by regulating the expression of IGF-1, VEGF, KGF, and TGF-β, participating in SHH/Gli and Wnt/β-catenin pathways. Importantly, the nanoformulations had no obvious skin irritation. Thus, our study showed that CAR-loaded liposomal formulation has potential application in the treatment of AGA.

Comparison of the Effectiveness of EMLA Cream, 2% Lidocaine Gel, and Ice Bag on Pain Intensity Caused by Venipuncture in Children Aged 6-12 Years

Background and Objectives Intravenous catheter placement is one of the most common invasive care measures performed by nurses. Considering the contradictory results obtained regarding the effect of local analgesic techniques, the present study was conducted to compare the effect of EMLA cream vs. 2% lidocaine gel vs. ice bag on pain intensity caused by venipuncture in children aged 6-12 years. Subjects and Methods In this clinical trial, 160 children undergoing elective surgery were selected according to the inclusion and exclusion criteria and were divided into 4 groups of 40 using block randomization method. In this study, pain intensity was measured based on patient self-report and by nurses during venipuncture while applying EMLA cream, 2% lidocaine gel, and ice bag using the numeric analog scale (NAS) and the FLACC scale which included 5 criteria for child behavior. The range of scores in both scales is recorded from 0 to 10, where 0 indicates absence of pain. The data were collected using dispersion indices. Kruskal-Wallis test and chi-square test were used to compare the numerical scale of pain and behavior between groups using SPSS-16 statistical software. Results The mean age of the participants was 7.79±1.79 years, and 80 (50%) were male. The results showed that the mean values of pain intensity based on the numerical scale in the control, EMLA cream, lidocaine gel, and ice bag group were 4±0.78, 0.9±0.75, 2.80±0.18, and 2.60±0.67, respectively. Moreover, there was a statistically significant difference between the groups according to numerical scale and behavioral scale (P&lt;0.001), with the EMLA cream group expressing a lower level of pain based on both scales. Conclusion The results of the present study showed that the use of all three methods of EMLA cream, lidocaine gel, and ice bag reduced pain during venipuncture. The EMLA cream was associated with a higher amount of pain reduction compared to the other two methods. Therefore, EMLA cream could be recommended to be used routinely in the target area one hour before catheter placement.

Demineralized dentin characteristics after application of Mauli banana stem gel

Background: Demineralization of dentin is a condition of dissolving minerals in peritubular dentin due to exposure to acids that release hydroxyapatite ions. To prevent dentin demineralization, a therapeutic agent that can inhibit the dissolution ability of hydroxyapatite ions is needed. One therapeutic agent that can be used is the Mauli banana (MB) stem gel. Purpose: To observe the characteristics of dentin demineralization after the use of MB stem extract gel. Method: Mandibular incisor bovine teeth were demineralized with lactic acid pH 4.5 for 72 hours and then treated with 25%; 37.5%; 50%; and 62.5% MB gel and Chlorhexidine 2% for one minute. All samples were soaked in artificial saliva with 1 mg/ml saliva of collagenase enzyme for 24 hours. The characteristic of dentin demineralization was observed by using scanning electron microscope/electron dispersive X-ray spectroscopy (SEM-EDX). Results: The SEM image in the control, Chlorhexidine, 25%; 37.5%; 50%; and 62.5% MB gel groups showed dentinal tubules of about 3.67–4.94 µm; 3.55–4 µm; 4.18–5.6 µm; 2.28–2.86 µm; 3.29–3.81 µm; and 2.42–3.17 µm in size. The EDX test found carbon (C), nitrogen (N), oxygen (O), sodium (Na), phosphorous (P), chlorine (Cl), and calcium (Ca) in all groups. The one-way Analysis of Variance (ANOVA) test results showed significant differences in the levels of C, N, O, Cl, and Ca between all groups, while the Na showed no significant differences. Conclusion: The MB can inhibit the demineralization of bovine dentin based on the decrease in the size of the dentinal tubules and increasing the C, O, P, and Ca.

In‐vitro evaluation of antimicrobial and anti‐inflammatory efficacy of the gelatin‐β‐cyclodextrin hydrogels as biodegradable carriers for rutin

AbstractThis work targeted synthesizing covalently crosslinked gelatin‐βcyclodextrin (Gel‐βCD) hydrogels via the Schiff‐base reaction between the amino groups of Gel and aldehydic groups of βCD produced from periodate oxidation. Fourier transform infrared (FTIR) spectra, scanning electron microscope (SEM), water uptake (WU) and thermogravimetric analysis (TGA) showed the chemical structure, surface morphology and thermal properties of the crosslinked Gel‐βCD hydrogels. Rutin was loaded into the crosslinked hydrogels (Gel‐βCD‐R) and release profile was investigated. The antimicrobial and anti‐inflammatory activities of Gel‐βCD‐R hydrogels were assessed against Pseudomonas aeruginosa (gram negative), Staphylococcus aureus (gram positive) and Candida albicans (fungal strain) and human red blood cells membrane protection as well. Results of FTIR spectra, SEM, WU and TGA analysis showed the successful Schiff‐base Gel‐βCD hydrogels synthesis having porous structure, high swelling behavior and good thermal stability. Rutin release behavior was controlled in the developed hydrogels and after 24 h at pH 7.4 about 88 % and 95 % for Gel‐βCD2‐R and Gel‐βCD4‐R, respectively. The formulation Gel‐βCD2‐R hydrogel showed a significant antimicrobial activity; 98.35 %, 75.26 % and 94.67 % inhibition growth for P. aeruginosa, S. aureus and C. albicans respectively. Besides, the anti‐inflammatory result was 92 % that nominates the formulation Gel‐βCD2‐R hydrogel as a promising antimicrobial and anti‐inflammatory alternative in drug delivery.

Effectiveness of Topical Ozone Gel Application in the Management of Postextraction Wound Healing: An In Vivo Study.

The purpose of the current study was to determine the effectiveness of topical ozone gel application in the management of postextraction wound healing. The current study involved a total of 40 participants. The patients were randomly placed into two groups with sample size estimated as n = 20 in each group. Group A: Control: patients received only saline irrigation and group B: patients receiving topical ozone gel. The surgical procedure was standardized for all groups, and local anesthesia was used during the procedure. After the removal of the mandibular third molar, the control group irrigated the socket with saline, whereas in the study group, the socket was filled with ozone gel. On the first, third, fifth, and seventh postoperative days, a single examiner evaluated each participant for postoperative mouth opening, discomfort, and patient satisfaction. The t-test was used to analyze quantitative data, whereas the Fisher exact test was employed to analyze qualitative data. Statistical significance was defined as a p value less than 0.05. On comparison of patient satisfaction, in the ozone gel group, 13 patients were very satisfied but in the control group, 8 patients were very satisfied. On comparison of pain intensity, on the 5th day, the complete absence of pain patients was more in the ozone gel group (12 patients) compared with the control group (4 patients). There was a statistically significant difference found between these two groups (p < 0.001). On comparison of mouth opening, on the 3rd and 5th day, mouth opening was better in the ozone gel group (29.22 ± 1.28 and 34.06 ± 0.09) compared with the control group (27.38 ± 1.03 and 31.14 ± 0.82), respectively. And there was a statistically significant difference found between these two groups (p < 0.001) on both the days. The current study came to the conclusion that using ozone gel significantly improves postoperative pain, mouth opening range, and promotes faster wound healing. The primary goals of postoperative care for exodontia patients have always been pain management and infection control. The most frequent postoperative consequences are pain and edema. Hence, ozone therapy can be used as an effective topical agent to manage postextraction pain and swelling in healthy patients without the need for excess medications. How to cite this article: Varghese LJ, Lahiri B, Penumatsa NV, et al. Effectiveness of Topical Ozone Gel Application in the Management of Postextraction Wound Healing: An In Vivo Study. J Contemp Dent Pract 2023;24(11):887-890.